Active NPI
Brenda Irene Greene, PH.D.
- Clinical Psychologist
- Massena, NY
National Provider Identifier
1972671675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009780
- Practice address
- 234 River Dr
Massena, NY 13662-4106 - Phone
- (315) 514-1785
- Fax
- (315) 514-1785
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 009780 | NY | Primary |
Addresses
Primary practice location
234 River Dr
Massena, NY 13662-4106
Mailing address
234 River Dr
Massena, NY 13662-4106
Phone (315) 514-1785
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2099638 | Other | MN | CIGNA BEHAVIORAL HEALTH |
| 6804763 | Other | NY | VALUE OPTIONS GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1972671675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 RIVER DR",
"city": "MASSENA",
"state": "NY",
"postal_code": "136624106",
"telephone_number": "315-514-1785",
"fax_number": "315-514-1785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 RIVER DR",
"city": "MASSENA",
"state": "NY",
"postal_code": "136624106",
"telephone_number": "315-514-1785",
"fax_number": "315-514-1785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "BRENDA",
"middle_name": "IRENE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "2099638",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS GHI",
"identifier": "6804763",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massena, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.